1. Assessment of the myocardial area at risk: comparing T2-weighted cardiovascular magnetic resonance imaging with contrast-enhanced cine (CE-SSFP) imaging—a DANAMI3 substudy.
- Author
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Göransson, Christoffer, Ahtarovski, Kiril Aleksov, Kyhl, Kasper, Lønborg, Jacob, Nepper-Christensen, Lars, Bertelsen, Litten, Ghotbi, Adam Ali, Schoos, Mikkel Malby, Køber, Lars, Høfsten, Dan, Helqvist, Steffen, Kelbæk, Henning, Engstrøm, Thomas, and Vejlstrup, Niels
- Subjects
CARDIOMYOPATHIES ,CARDIOVASCULAR disease diagnosis ,CONFIDENCE intervals ,LEFT heart ventricle ,MAGNETIC resonance imaging ,RESEARCH evaluation ,RISK assessment ,INTER-observer reliability ,DESCRIPTIVE statistics ,DIAGNOSIS ,CARDIOVASCULAR diseases risk factors - Abstract
Aims Myocardial salvage following treatment for ST-segment elevation myocardial infarction is prognostic for morbidity and mortality. Studies with myocardial salvage as endpoint rely on valid assessment of the myocardial area at risk (AAR). T2-weighted cardiovascular magnetic resonance (CMR) imaging is the preferred method to assess the AAR. However, T2-weighted imaging can be of poor image quality and uninterpretable. Contrast-enhanced (CE) cine imaging can also show AAR and our aim was to investigate if CE-cine can replace T2-weighted imaging. Cine imaging is part of a standard CMR-protocol and implementing CE-cine imaging for assessment of the AAR would mean shorter investigation time. Methods and results As a DANAMI-3 substudy, we performed successful dual imaging of the AAR in 166 participants using both T2-weighted short tau inversion recovery (T2-STIR) and CE-cine imaging. T2-STIR imaging was non-diagnostic in nine and CE-cine in one scan during the period. CE-cine measured 4.7% of left ventricle (LV) [95% confidence interval 3.2–6.2%] smaller AAR compared with T2-STIR images (P < 0.001). Visual analysis of a plot of infarct size vs. AAR showed an overestimation of the AAR when measured with T2-STIR images. There was no difference in AAR with CE-cine in an interobserver analysis of 46 scans [1.2 g (standard deviation 9.5), P = 0.42]. Conclusions CE-cine imaging shows good internal consistency in assessment of the AAR. A visual inspection reveals possible overestimation of AAR with T2-STIR images. There is good interobserver agreement in the analysis of CE-cine imaging. CE-cine can replace T2-STIR imaging resulting in a more valid assessment of the myocardial AAR. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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